Medications for Lipid Disorders

The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included. Ask your doctor if you need to take any special precautions. Use each of these medications only as recommended by your doctor, and according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

Note:
Be sure to tell your doctor what other prescribed or over-the-counter medications, supplements, or herbs you are taking; they could interact with your medications.

If your cholesterol level is elevated, your doctor may recommend medication in addition to diet and lifestyle changes. The decision to start cholesterol-lowering drugs depends not only on your cholesterol level but also on your overall heart-disease risk. Heart disease risk factors include age, obesity, family history, smoking, diabetes, and high blood pressure.

Statins lower total blood cholesterol, LDL cholesterol, and triglyceride levels. They also lower heart disease risks. The drugs are usually taken daily with dinner or in the evening. Your doctor may measure your blood cholesterol levels regularly while you are taking these drugs.

Even if you currently have no known coronary heart disease (CHD), you may benefit from taking statin (cholesterol-lowering) medications, particularly if your cholesterol levels are elevated. The medication may reduce the incidence of
heart attack
,
stroke
, and death.

Significant side effects that have been reported with the use of statin medications include:

Headache

Muscle pain and/or damage

Rash

Liver damage (rare)

Bile Acid Sequestrants

Common names include:

Cholestyramine

Colestipol

Colesevelam

Bile acid sequestrants lower cholesterol levels by changing the way that cholesterol is metabolized. The drugs are in powder form and are taken with meals to decrease side effects. They should not be taken within hours of any other medications. Usually you should take other medications either one hour before or four hours after taking this medication.

Niacin is a B vitamin. At higher doses, it can lower cholesterol levels and triglycerides. It is not known how it works. Niacin should be taken with meals, 2-3 times per day, or once a day with the extended-release pill.

Possible side effects can include, but are not limited to:

Flushing

Itching

Rash

Indigestion

Fibric Acid Derivatives

Common names include:

Gemfibrozil

Fenofibrate

Fibric acid derivatives are usually taken to lower triglyceride levels and increase HDL (good) cholesterol. They may also help lower LDL cholesterol.

Ezetimibe lowers both total cholesterol and LDL (bad) cholesterol. It works by a different mechanism than the statins by decreasing the amount of cholesterol that your body absorbs.

Possible side effects include, but are not limited to:

Abdominal pain

Fatigue

Allergic reaction—swelling of face, lips, tongue, or throat that may cause difficulty breathing

Joint aches

PCSK9 Inhibitors

PCSK9 inhibitors are a class of medications that can lower LDL cholesterol levels. The medications are only available in injection form and need to be given every 2 to 4 weeks under the skin. The experience with these drugs is still limited. They are expensive and some insurance companies do not cover them.

Common names include:

Alirocumab

Evolocumab

Significant side effects that have been reported with the use of statin medications include:

Flu-like symptoms

Nausea

Joint pain

Reaction at the injection site

Special Considerations

Follow these general medication guidelines:

Take your medication as directed. Do not change the amount or schedule.

Ask what side effects could occur. Report them to your doctor.

Talk to your doctor before you stop taking any prescription medication.

Do not share your prescription medication.

Medications can be dangerous when mixed. Talk to your doctor or pharmacist if you are taking more than one medication, including over-the-counter products and supplements.

Plan ahead for refills as needed.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

American College of Cardiology/American Heart Association. 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults.
J Am Coll Cardiol. 2013: early online. Available at:
http://circ.ahajournals.org/content/early/2013/11/11/01.cir.0000437738.63853.7a. Accessed March 9, 2017.

How is high blood cholesterol treated?
National Heart, Lung, and Blood Institute
website. Available at:
http://www.nhlbi.nih.gov/health/health-topics/topics/hbc/treatment. Updated March 30, 2016. Accessed March 9, 2017.

Prevention and treatment of high cholesterol. American Heart Association website. Available at:
http://www.heart.org/HEARTORG/Conditions/Cholesterol/PreventionTreatmentofHighCholesterol/Prevention-and-Treatment-of-High-Cholesterol%5FUCM%5F001215%5FArticle.jsp#.VxflXE2FMdU.
Updated August 30, 2016. Accessed March 9, 2017.